Will a columelloplasty straighten my nose? (photos)

Question

I have been to see a doctor who has said that I need a columelloplasty what is this exactly? Will my nose look better after it?

Steven M. Denenberg, MD · Answer

I'll just tell you how I see it. The asymmetry at the bottom of your nose might be just the bottom of your septum pushed off to the right, presenting itself in your nostril. If that's the case, then you need a septoplasty, where the septum is straightened, and the columella is left alone.But more commonly, it's a combination of the septum and the columella. The bottom of the septum is pushing part of the columella off to the right, and correcting the septum will only partially correct the problem, probably not very much.The problem is that the cartilages of the columella are the same as the cartilages of the tip of the nose. If you work on the columella, trying to just straighten it, either you won't do enough to straighten it, or if you do enough, you'll torque the tip of the nose and make it look different, probably not in a good way.The base view of the nose isn't important, because people don't see you in that position. My recommendation: either have just a septoplasty to see how much improvement you can get from re-positioning the septum, or have a full rhinoplasty done if other parts of your nose bother you as well, or don't have surgery on the nose, but don't have a "columelloplasty." I've been doing rhinoplasty for 31 years, and I've never done an isolated columelloplasty.See the "Web reference" link, just below my response: I made a computer morph of one of your photos, to show the kinds of changes that some people might want to consider with your nose. You should understand that the changes I demonstrated in the morph require advanced techniques, techniques that most plastic surgeons cannot handle.  Be sure to read the section in the "Web reference" link on how to stay out of trouble while searching for a rhinoplasty surgeon.

James M. Ridgway, MD, FACS · Answer

Hello, 
Columelloplasty is a technique to dislocate and reposition the nasal septum in
a midline position, behind the columella. This will improve the appearance of
your nose from underneath as the septum appears to be deviated into your right
nostril. Your ability to breath, if this is your only impediment in breathing,
will significantly improve as well.

Be healthy and be well,

James M. Ridgway, MD, FACS

Stefano Cotrufo, MD, PhD, EBOPRAS · Answer

Colummellaplasty is intended only to improve the symmetry between your nostrils - as you look at them from the bottom.With a full rhinoplasty instead you can correct the also bulbous tip along with a reduction of the dorsal hump - that you see from the from the side view.With a full rhinoplasty you could also achieve a better refinement of the columella because this will give your PS also the chance to control some septal deviation behind the nostril asymmetry.I think that the final decision depends on what you really wish to achieve and how much you are willing to put into your surgery.I usually invite my patients to correct all aspect they are not happy with in a single stage rather than coming back under the knife again and again. I perform many revision rhinoplasty and for sure the surgery takes longer, is more expensive and results are less predictable that after primary surgery.I would recommend a second and third opinion before taking a decision.With best regards,

Jawed Tahery, FRCS · Answer

Dear chez2121,thanks for for sharing your pictures. You have a small nasal hump, slightly round tip and columella dislocation!these all can be managed with a septorhinoplasty and not a columellapladty!!best wishes Mr J Tahery ChesterUK

William Portuese, MD · Answer

A columella plasty will not straighten the crooked nose, it will only straighten a crooked columella which is the tissue between both nostrils. A full rhinoplasty is required to straighten a crooked nose.

Will a columelloplasty straighten my nose? (photos)

Answers (5)

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